THE ROLE OF MODERN TECHNOLOGIES IN DISPENSARY FOLLOW-UP OF ARTERIAL HYPERTENSION PATIENTS IN TYUMEN REGION, INCLUDED INTO THE CHRONIC NON-COMMUNICABLE DISEASE REGISTRY

Abstract

Aim . To assess the influence of sex, type of settlement on the dynamics of risk factors (RF) and treatment adherence in arterial hypertension (AH). Material and methods . Randomly, 1704 AH patients selected and investigated in 3 outpatient institutions of Tyumenskaya oblast. Mean patients age 62±7,5 y.o., 31,5% — males, 18,7% — rural inhabitants. The prevalence of RF evaluated for cardiovascular diseases, as treatment adherence to antihypertension therapy (AHT). Patients were selected to the groups of active observation and control. Active observation group received SMS and e-mail with preventional kind content. General practitioners were educated on the specifics of dispensary follow-up of AH patients. In 12±3,2 months patients were assessed second time. The efficacy of RF correction was evaluated, as AHT adherence, according to sex and settlement type. Results . At the baseline, the prevalence of RF was as following: current smokers 24,1%, hypodynamic 64,0%, salt overconsuming 47,0%, insufficient vegetables and fruits intake 38,0%, elevated total cholesterol (TC) and low density lipoproteides (LDL) in 89,0% and 90,7%, respectively, body mass index (BMI) ≥30 kg/m2 in 49,5%, visceral obesity in 39,0%. Regularly received treatment 39,9%, of those effectively — 39,0%. In one year of follow-up, patients were investigated second time. In the active follow-up group there was 6% decrease of smoking rate (p<0,01); by 20,2% and 15,9% increased the number of those achieved target TC level (p<0,01) and LDL (p<0,01). There was significant number of BMI decrease and target waist circumference — 7,4% (p<0,01) and 6,1% (p<0,05), resp. By 14,3% the number of adherent to AHT increased (p<0,01) and by 10,9% — of those with effective treatment (p<0,01). Males quit smoking more frequently, and females reached target LDL levels, regularly took therapy and were more effective. Citizens more commonly reached target levels of TC, LDL, BMI, and took AHT more frequently. Conclusion . The proposed model of active follow-up of AH patients makes it to improve the control of dyslipidemia, obesity, smoking, and to increase treatment adherence.